PURPOSE: We investigated the usefulness of preoperative fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) as a tool for predicting recurrence patterns to select patients for liver resection as an initial surgical strategy for hepatocellular carcinoma. METHODS: Sixty-three consecutive hepatocellular carcinoma patients undergoing FDG-PET were enrolled. They were classified according to the initial recurrence patterns (beyond the Milan criteria [MC], within the MC, and no recurrence) and the time intervals before initial postoperative recurrence (within 1 year, after 1 year or later, and no recurrence). The tumor-to-nontumor ratio (TNR) obtained by FDG-PET and survival rates were compared among the groups. RESULTS: TNR in the recurrence within the MC group (1.9 ± 1.6) and no recurrence group (1.3 ± 1.5) was significantly lower than that in the beyond the MC group (2.9 ± 2.6). TNR was an independent predictive factor of recurrence patterns in multivariate analysis. TNR in the groups with recurrence after 1 year or later (1.6 ± 0.8) and no recurrence (1.3 ± 0.5) were significantly lower than that in the within 1-year group (3.1 ± 2.7). TNR was an independent predictive factor of the interval before initial recurrence by multivariate analysis. CONCLUSIONS: Preoperative FDG-PET predicts hepatocellular carcinoma recurrences within the MC or no recurrence and recurrences after 1 year or later. FDG-PET may be useful for selecting appropriate patients for liver resection as an initial surgical strategy.
PURPOSE: We investigated the usefulness of preoperative fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) as a tool for predicting recurrence patterns to select patients for liver resection as an initial surgical strategy for hepatocellular carcinoma. METHODS: Sixty-three consecutive hepatocellular carcinomapatients undergoing FDG-PET were enrolled. They were classified according to the initial recurrence patterns (beyond the Milan criteria [MC], within the MC, and no recurrence) and the time intervals before initial postoperative recurrence (within 1 year, after 1 year or later, and no recurrence). The tumor-to-nontumor ratio (TNR) obtained by FDG-PET and survival rates were compared among the groups. RESULTS: TNR in the recurrence within the MC group (1.9 ± 1.6) and no recurrence group (1.3 ± 1.5) was significantly lower than that in the beyond the MC group (2.9 ± 2.6). TNR was an independent predictive factor of recurrence patterns in multivariate analysis. TNR in the groups with recurrence after 1 year or later (1.6 ± 0.8) and no recurrence (1.3 ± 0.5) were significantly lower than that in the within 1-year group (3.1 ± 2.7). TNR was an independent predictive factor of the interval before initial recurrence by multivariate analysis. CONCLUSIONS: Preoperative FDG-PET predicts hepatocellular carcinoma recurrences within the MC or no recurrence and recurrences after 1 year or later. FDG-PET may be useful for selecting appropriate patients for liver resection as an initial surgical strategy.
Authors: Jae Hyun Han; Dong Goo Kim; Gun Hyung Na; Eun Young Kim; Soo Ho Lee; Tae Ho Hong; Young Kyoung You Journal: World J Gastroenterol Date: 2014-12-07 Impact factor: 5.742